2026 Annual Medical Service Award Nomination Form
The Annual Medical Service Awards will be held October 2, 2026. Deadline for Nominations is August 14, 2026. All nominees must be US citizens and legal residents of Lee County Florida. Nominees do NOT need to be members of the Lee County Medical Society. Anybody can nominate. For Physician nominations, they must have practiced in the past or still have their practice located within Lee County. Past winners are not eligible.
Are you nominating a Physician or Non Physician?
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Physician
Non-Physician
Please chose the best Physician Award that suites your nominee:
Citizenship and Community Service Award: For outstanding leadership and/or public service above and beyond the call of duty as a practicing physician. This can include service within the local community or abroad, such as, but not limited to, contributions to international aid missions or other pro bono work
Scientific Achievement Award: This award is given in recognition of outstanding work in the areas of scientific medical research. This will include both basic science and clinical research. Work done while residing within the county will be emphasized although previous research outside of the region will be considered.
Leadership and Professionalism Award: This award will underscore the County Medical Society’s continuing dedication to the principles of medicine and the highest standards of medical practice. The ideal candidate for the award would:1. Have distinguished himself/herself as a leader in medicine within our community or beyond. Have made an outstanding contribution through active service in the medical community, improving the profession's effectiveness, upholding the practice of medicine through advocacy of policies, provision and/or the organization of services, and/or scholarly writings that demonstrate effective leadership and professionalism
Rising Physician Award: This award is for the physician who is in the first 10 years of their professional career. They exemplify leadership and are a role model for others. This physician exhibits dedication to the healthcare industry and to the Lee County community. They show promise in making further contributions to the medical field.
Lifetime Achievement Award: Nominees should have contributed substantially to the goals and ideals of the medical profession. The nominees' contributions shall have been sustained and substantial over a significant term of service in Lee County.
In Memory of an Outstanding Physician Award: In memory of an outstanding physician for substantial contributions to our medical community. This may include, but not necessarily be limited to, lasting and significant achievements in the areas of community service, scientific or clinical research, medical education, leadership, medical ethics or professionalism. Nominee must have practiced or worked in Lee County
Health Education Award: This award recognizes the professional or public health education activities of a physician, and may include a physician who educates other physicians and healthcare workers. Physicians involved in non-promotional community service education also considered.
Please chose the best NON-Physician Award that suites your nominee:
Non-Physician Appreciation Award (i.e., nurses, nurse practitioners, physician assistants and other medial staff)For exemplary and a lasting impact to medicine above and beyond the call of duty, as a (non-physician) member of the medical profession.
Distinguished Layperson’s Service Award (i.e., medical support staff, medical administration and medical education)This award shall be made to an individual who has contributed to the achievement of the ideals of medicine through the advancement of medicine, medical science, medical research, medical education or medical care. This award includes those who support the medical profession through the delivery of medicine or medical research/education but are not themselves physicians, nurses, nurse practitioners, physician assistants or other medical staff.
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Nominee's Full Name (please note that current LCMS Board Members or Past Awardees are not eligible)
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First Name
Last Name
Nominee's Contact Email
example@example.com
Nominee's Mobile Number
Please enter a valid phone number.
Format: (000) 000-0000.
Is the nominee currently a resident of Lee County?
Yes
No
Nominee's Professional Board of Certification:
Nominee's Company Information:
Is the nominee's current or past physician practice located within Lee County?
Yes
No
In Memory of Nominee - family member
First Name
Last Name
In Memory of Nominee - family member's phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Your Full Name
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First Name
Last Name
Your Contact Email
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example@example.com
Your Mobile Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Why are you nominating this person?
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